Blogpost 1: The Soul of a Doctor

The Soul of a Doctor attempts to tackle four different aspects (communication, empathy, easing suffering and loss, and finding a better way) of patient care through the stories of Harvard medical students. These essays feature some of the best and worst aspects of health care today and are used to try to find what it means to be a doctor and to take care of a patient when they are their most vulnerable. I found that the communication section had some of the most interesting stories. One story, titled “No Solution,” featured an ethical dilemma on prescribing medication. A man came into the doctor’s office asking for a prescription of Percocet – only he would not be the one taking the medication. He was planning on giving the medication to his elderly neighbor who was in a lot of pain and refused to see a doctor. The patient was upfront and honest with the doctor and medical student about his intentions so they had to decide on what the best thing to do was. The medical student wanted to help the elderly woman, perhaps by visiting her and diagnosing the underlying cause of the pain. However, according to the physician, this was not a practical solution. They must decide whether to give the medication or not give the medication. Because it is against the law and would not help the elderly woman long term, the obvious choice was to not prescribe the medication. This brought upon some problems for the patient, however, because he had to find another way to get the medication – presumably, off the streets. The medical student struggled with this lose-lose situation because she felt it was as though the patient was being punished for being honest. Surely, there was a way to help the woman so that they would not have to get the drugs illegally and she would no longer be in pain. Perhaps it was the best idea to see the woman, though it would take more time and effort out of the physician’s day. One of my favorite stories in the empathy section was one titled “Coney Island.” This featured a young woman with cervical cancer. It was an interesting case because she had to have a stent placed in her ureter because the tumor was impinging on it. In getting to know this patient, the medical student learned that she was from Coney Island and had two kids, both under the age of five. This left the medical student with some cognitive dissonance because she really connected with this patient, but was still excited to see her go through the pain of surgery just because it was interesting. What was especially hard for the student was to think about how excited medical professionals get when they see an unusual case, but the patient is simultaneously going through the worst part of their life. When trying to explain this phenomenon to another student, the student simply responded that cervical cancer is an STD – implying that the patient “deserved” it, so it is okay to be excited for the surgery. I think this speaks a lot about health care and biases. Regardless of the patient’s lifestyle and how they acquired an illness, health care providers should not treat them any differently from other patients. It is not their business what the patient does in his/her spare time, it is only their business what the patient is doing right then, which is seeking help and treatment. What do you guys think about these two cases? Should the doctor in “No Solution” have tried harder to help the elderly woman instead of just denying the prescription and moving on? Do you feel weird about the excitement doctors, nurses, etc. get when an interesting case comes in, knowing that the patient is suffering? I will discuss the last two aspects of patient care, easing suffering and loss and finding a better way, in my last blogpost.